During the recent Senate HELP hearing titled “Community Health Centers: Saving Lives, Saving Money,”Advocates for Community Health (ACH) was privileged to be invited to speak on behalf of the 30 million Americans who depend on community health centers for their primary and comprehensive care. More than ever, community health centers are at risk of losing critical funding to keep their doors open and serve communities in need. A new report from The George Washington University estimates that up to 15 million Medicaid enrollees will lose coverage by the end of this redetermination process. In addition, the 340B program, a vital revenue stream for federally qualified health centers, is slowly being eroded by the actions of state policymakers, pharmaceutical companies, and pharmacy benefit managers.
Through our CHC Invest campaign, ACH is calling on Congress to not only increase funding for FY24 in the upcoming reauthorization, but to also invest $30 billion in community health centers (CHCs) by 2030. By 2030, CHCs aim to: serve 40 million patients per year, train 25,000 providers, increase by 25% the number of CHCs that reach clinical benchmarks, increase by 20% the number of CHCs participating in value-based care, and develop and bring to scale at least 15 interventions to address social determinants of health.
“For every dollar invested in primary care, $13 is saved in downstream costs. We know that health centers specifically save $24 billion to the system a year. We also know that for every dollar invested in health centers, $3 is returned. Investing in health centers doesn’t just saves lives, it saves money,” said ACH CEO Amanda Pears Kelly during her testimony.
Pears Kelly was joined by CEO of Indiana Primary Health Care Association Ben Harvey, Carolina Health Centers President and Chief Executive Officer and National Association of Community Health Centers Board Member Sue Veer, Kaiser Permanente Tyson School of Medicine Assistant Profession Robert S. Nocon, MHS, PhD, and Government Accountability Office (GAO) Managing Director Jessica Farb, MS.
“Health centers are nonprofit, patient-governed organizations that provide high-quality, comprehensive primary health care to people living in medically underserved areas. In 2021, health centers nationally reached the historic milestone of serving 30 million Americans in a single year,” stated Harvey. In addition, he spoke of the instrumental part health centers play in rural areas where they are the sole option for care—including expanding to fill gaps left by the closure of critical access hospitals.
Veer stated that health centers address social determinants of health by assisting the community with homelessness, joblessness, domestic violence, parenting skills, food insecurity, and transportation. She also pointed out that behavioral health and substance use disorder services at health centers are provided by integrated in-house providers in collaboration with local mental health and substance use agencies, but the lack of third-party reimbursement makes care challenging.
In the Q&A portion, HELP Chair Senator Bernie Sanders (I-VT) shared a George W. Bush quote on CHCs to highlight their historic bipartisan support, calling them a “wise use of taxpayer money” and adding that “every poor county in America [should have] a community health center.” He then asked witnesses their views on the expansion of health centers. Pears Kelly pointed out that health centers can scale to meet the needs of the community with adequate investment and that they are uniquely poised to improve health outcomes and transform the communities they serve.
The conversation was positive, with most senators expressing general support for continued community health center funding. Questions regarding the 340B program were raised, with Ranking Member Senator Bill Cassidy (R-LA) focusing on the misuse of the program by bad actors and how 340B income impacts health center funding needs overall. Senator Cassidy also sent a letter to GAO prior to the hearing requesting updated information on CHC revenue streams as the committee looks to reauthorizing the Health Center Trust Fund. Cassidy also emphasized the committee’s commitment to reauthorizing the Trust Fund before it expires in September in a “fiscally responsible way.”
Additionally, CHCs’ role in addressing behavioral health needs were raised with multiple senators expressing their concern about workforce challenges. Senator Susan Collins (R-ME) said a perfect storm is brewing – unprecedented staff turnover, threats to 340B, and the covid-related slow return of patients. Senator Lisa Murkowski (R-AK) asked about ways to use the National Health Service Corps (NHSC) to bolster the CHC workforce. Pears Kelly responded by stating that the NHSC is important to the CHC workforce, noting the Corps’ strengths in diversity and retention and that ACH is calling for increased investment in this program. She advocated for keeping NHSC funding at least at the levels provided in the American Rescue Plan Act.
We are encouraged by the bipartisan focus on strengthening and supporting the health center program. We look forward to continuing to work with the HELP Committee and other health center advocates to push for not only the reauthorization of health center funding, but long-term, increased investments in the program that will ensure CHCs can fulfill their mission and serve patients in need. To watch the full recording of the hearing, please visit the HELP Committee hearing page.
Amanda Pears Kelly’s Full Testimony
Bracing for a Difficult Year: Medicaid Unwinding’s Impact on Health Centers and Our Patients
Closing the Primary Care Gap: How Community Health Centers Can Address the Nation’s Primary Care Crisis
Upcoming ACU Webinar: Best Practices and Lessons Learned for Medicaid Redetermination